Category Archives: DOJ, DC and inside the Beltway

What Jihad in Paris Looks Like

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The President of France, Hollande is a passive leader, precisely the same as Barack Obama. Hillary after the CBS debate held on Saturday night, is just as passive. All of them are by themselves a danger to the security of the homeland.

 

 

Fair warning for the last photo at the bottom, but it is important to absorb…it can and has happened here.  Exactly what is a ‘watch list’ in America, what is being watched by those on the list? Too little too late as noted by the Tsarnaev brothers. Time to ask hard questions and make new demands.

The FBI has already dispatched a team to Paris for forensic and investigation with French intelligence services. Meanwhile:

FNC:  French man believed to be directly involved in Friday’s Islamic terror attack in Paris that killed 129 and injured 352 was on the run Sunday afternoon and was being hunted by authorities, French security officials said.

The man, one of three brothers believed involved in the killings in central Paris, rented the black Volkswagen Polo used by a group of hostage-takers that left at least 89 people dead inside the Bataclan concert hall, one official said.

One other police official said the manhunt is believed to involve at least one suspect. Both officials spoke on condition of anonymity because the investigation was ongoing. One of the suspect’s brothers has been arrested in Belgium and another brother died in the attack, the first official said.

Three of the seven Islamist suicide bombers have already been identified as French citizens, as was at least one of seven other people arrested in neighboring Belgium in connection to the deadly attacks.

One suicide attacker, who was identified from a skin sample, had been living in a Paris suburb, French police said Sunday. A Belgian official said two of the seven suicide bombers were French men living in Brussels, and one of the attackers was living in the Molenbeek neighborhood, which is considered a focal point for religious extremism and fighters going to Syria. Among the seven people arrested  was another French citizen living in the Belgian capital.

The new information highlighted growing fears of possible homegrown terrorism in France, a country that has exported more jihadis than any other in Europe.

Ismael Omar Mostefai, a 29-year-old French citizen who had been flagged for ties to Islamic radicalism, was identified Sunday as one of the assailants by a French judicial official who spoke to the Associated Press on condition of anonymity because the investigation is ongoing.

Mostefai’s ID comes as Balkan authorities work to track the travels of a man whose Syrian passport was found next to a dead suicide bomber at France’s national stadium on Friday night. It is still not clear if that Syrian passport is authentic, or if it belonged to the dead bomber. European officials say there is a brisk trade in fake Syrian passports to help people obtain refugee status in the European Union.

Serbian police said Sunday the owner of the passport, identified only as A.A., formally requested asylum in Serbia. Prosecutor Francois Molins told Sky News the passport was found at the Stade de France bombing site and belonged to a Syrian citizen born in 1990.

Officials said the passport holder entered Greece on Oct. 3 through Leros, one of the eastern Aegean islands that tens of thousand of people fleeing war and poverty have been using as a gateway into the 28-nation EU. Serbian police said the holder of the passport then registered at its border entry with Macedonia on Oct. 7. Croatian police said the passport holder was checked at a refugee center on Oct. 8, but the man was not flagged as suspicious and continued his journey toward Hungary and Austria, according to police spokeswoman Helena Biocic.

The FBI is sending to Paris a team of agents that specialize in recovering information from electronic devices, the New York Times reported on Sunday. The FBI is reportedly anticipating a bevy of information coming from French officials in the days ahead and wants to have sufficient manpower to handle and interpret it.

While investigators work to figure out how the attack was planned and if anyone connected with it is still at large, the so-called “City of Light” has gone dark as top Paris tourist attractions such as the Eiffel Tower and the Louvre art museum remain closed in the wake of the attacks perpetrated by Mostefai and seven other terrorists. The Islamist attackers wielded AK-47s and wore suicide belts while carrying out a series of coordinated attacks at six sites around Paris on Friday night.

Mostefai, identified by his fingerprints, was one of the terrorists inside the Bataclan concert hall, where at least 89 people were murdered during a concert by the American band Eagles of Death Metal, Sky News reported. He was known to the French Secret Service for his radicalism, Fox News has confirmed.

Little is known about Mostefai’s background, but French investigators have learned he grew up in a tough French housing project and turned to radicalism five years ago.

The mayor of the French city of Chartres, Jean-Pierre Gorges, identified Mostefai as a resident in a Facebook post, and Molins told Sky News that Mostefai had a criminal record, but didn’t spend time in jail.

“In 2010, he was blacklisted by the police due to extreme behaviors, but never been classified into any illegal extremist groups,” Molins said.

An unidentified prosecutor told AP Mostefai was identified from fingerprints on a finger found in the carnage of the Paris attacks Friday night.

“In 2010, he was blacklisted by the police due to extreme behaviors . . .”

– Prosecutor Francois Molins

The official said Mostefai’s father, a brother and other family members have been detained and are being questioned, according to the AP.

ISIS has claimed responsibility for the apparent meticulously planned attacks and has warned that France would remain at the “top of the list of targets” over its airstrike on the militant group in Syria and Iraq.

A Seat car containing Kalashnikov rifles was found abandoned by police in Montreuil, approximately 4 miles east of Paris. Molins said Saturday that gunmen armed with automatic rifles pulled up in that model car before opening fire, killing 15 people and injuring 10, but a French official told the AP that authorities couldn’t immediately confirm if it was the same black Seat car linked to the AK-47 attacks on the Le Carillon bar and the Le Petit Cambodge restaurant on Rue Alibert in the city’s 10th district.

Belgian police arrested three in connection with the terror assaults Saturday. Belgium Justice Minister Koen Geens told the VRT network that the arrests came after a car with Belgian license plates was seen Friday night close to the Bataclan concert hall, scene of the deadliest assault, where at least 89 people were massacred by attackers armed with AK-47s and explosives.

Geens said the car was a rental and the arrests stemmed from police raids conducted in the St. Jans Molenbeek neighborhood in Brussels.

French President Francois Hollande called the attacks an “act of war” in a nationally televised address Saturday. Hollande vowed France “will be merciless toward the barbarians of Islamic State group.”

ISIS, in an online statement, described Paris as “the carrier of the banner of the Cross in Europe” and described the attackers as “eight brothers wrapped in explosive belts and armed with machine rifles.”

French police said Saturday they believed all of the attackers were dead, but were still searching for possible accomplices. The French prosecutor’s office said seven of the eight assailants died in suicide bombings.

 

 

 

 

White House, College Campuses, Rolling Stone Magazine

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Yup, I got a notion earlier today and with a few search terms and additional clicks….low and behold it seems it all began in 2013 and White House personnel and Joe Biden and Valerie Jarrett is at the core. The activists are invited to the White House to systematically launch protests at college campuses…..it is working.

From the White House website: Valerie Jarrett Chair of the White House Council on Women and Girls, and Senior Adviser and Assistant to the President for Intergovernmental Affairs and Public Engagement 

Featured
FACT SHEETS AND REPORTS

Fact Sheet: The Equal Futures Partnership — From Promise To Progress (Download PDF)

Fact Sheet: the Obama Administration’s Comprehensive Efforts to Promote Gender Equality and Empower Women and Girls Worldwide (Download PDF)

Fact Sheet: the Equal Futures Partnership to Expand Women’s Political and Economic Participation

Fact Sheet: the Equal Futures Partnership and United States Commitments to Expand Women’s Political and Economic Participation

Keeping America’s Women Moving Forward (PDF)

Equal Pay Task Force Accomplishments (PDF)

American Jobs Act: Impact for Women (PDF)

Women and Girls in Science, Technology, Engineering, and Math (PDF)

Women and Girls of Color: Addressing Challenges and Expanding Opportunity (PDF)

Obama Administration Record on Women and Girls (PDF)

  1. Remember that fake 9000 word fake rape story at the University of Virginia posted in Rolling Stone? White House Adviser Introduced Fake Rape Story’s Jackie to ‘Rolling Stone’   The story turned out to be a hoax; Jackie’s tale was fiction. Now, in court documents we learn that the author of the piece, Sabrina Rubin Erdely, learned about Jackie from Emily Renda, an adviser on the White House Task Force to Protect Students from Sexual Assault, who told the Jackie story in Senate testimony months before the Rolling Stone story, Renda was also a UVA employee.  
  2. Then we have the Department of Education, which was headed by Arne Duncan and he recently stepped down. Catherine Lhamon, who heads the Department’s civil rights wing, was identified in a letter sent last month by University of Virginia Dean of Students Allen Groves to Steve Coll and Sheila Coronel, the two Columbia Journalism School deans who conducted a review of the Nov. 19 article, written by disgraced reporter Sabrina Rubin Erdely. Groves’ letter was included as a footnote to the Columbia deans’ report, which was released on Sunday and cataloged the failures and lies that led to the article’s publication.
  3. Then we have Joe Biden and one of his top aides, Lynn Rosenthal. WASHINGTON — Vice President Joe Biden is losing his top adviser on violence against women, The Huffington Post has learned. Lynn Rosenthal, who has been a senior adviser to Biden since July 2009, will step down Friday. She is moving on to become the Vice President of External Affairs at the National Domestic Violence Hotline, and will remain in Washington, D.C.

    Rosenthal has coordinated the White House’s efforts to reduce domestic violence homicides, address domestic violence in the workplace and raise awareness about the effects of violence on youth. She’s also served on the White House Council on Women and Girls.

    Violence against women is one of Biden’s signature issues. As a senator, he wrote the 1994 Violence Against Women Act, and he was instrumental in ushering through the law’s reauthorization as vice president in 2013, when House Republicans unexpectedly held it up over its inclusion of new protections for Native American victims of abuse.

    He regularly works to keep the issue in the spotlight. During remarks last month at the White House Tribal Nations Conference, he described domestic violence as an “epidemic” that “cuts to the very core of how we measure ourselves as a society.”

 

FBI: Hillary and Gross Negligence

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We cant officially know at the point who on Hillary’s team has met with the FBI and made statements or answered questions, Conversations with the FBI are not under oath, but still making false statements or responses is a felony. It must also be noted that even Barack Obama said he was NOT aware of a private server but did know and in fact the White House did communicate with Hillary and her team via private, non-governmental email addresses.

It is noteworthy that this snippet of news of the FBI widening their investigation is even in the public domain. The FBI is reviewing all emails to determine themselves which should be classified and those that are not deemed so. If Hillary never revealed to Obama himself that she was using a private server and providing him notice is itself a standard to prosecute her.

Documents and information includes: any material in written form, books, sketches, photographs, blueprints, maps, notes documents, plans or comments.

FBI expands probe of Clinton emails, launches independent classification review

FNC: The FBI has expanded its probe of Hillary Clinton’s emails, with agents exploring whether multiple statements violate a federal false statements statute, according to intelligence sources familiar with the ongoing case.

Fox News is told agents are looking at U.S. Code 18, Section 1001, which pertains to “materially false” statements given either in writing, orally or through a third party. Violations also include pressuring a third party to conspire in a cover-up. Each felony violation is subject to five years in prison.

This phase represents an expansion of the FBI probe, which is also exploring potential violations of an Espionage Act provision relating to “gross negligence” in the handling of national defense information.

“The agents involved are under a lot of pressure and are busting a–,” an intelligence source, who was not authorized to speak on the record, told Fox News.

The section of the criminal code being explored is known as “statements or entries generally,” and can be applied when an individual makes misleading or false statements causing federal agents to expend additional resources and time. In this case, legal experts as well as a former FBI agent said, Section 1001 could apply if Clinton, her aides or attorney were not forthcoming with FBI agents about her emails, classification and whether only non-government records were destroyed. It is not publicly known who may have been interviewed.

Fox News judicial analyst Judge Andrew Napolitano said the same section got Martha Stewart in trouble with the FBI. To be a violation, the statements do not need to be given under oath.

“This is a broad, brush statute that punishes individuals who are not direct and fulsome in their answers,” former FBI intelligence officer Timothy Gill told Fox News. Gill is not connected to the email investigation, but spent 16 years as part of the bureau’s national security branch, and worked the post 9/11 anthrax case where considerable time was spent resolving discrepancies in Bruce Ivins’ statements and his unusual work activities at Fort Detrick, Md.

“It is a cover-all. The problem for a defendant is when their statements cause the bureau to expend more time, energy, resources to de-conflict their statements with the evidence,” he said.

Separately, two U.S. government officials told Fox News that the FBI is doing its own classification review of the Clinton emails, effectively cutting out what has become a grinding process at the State Department. Under Secretary for Management Patrick Kennedy has argued to both Director of National Intelligence James Clapper and Congress that the “Top Secret” emails on Clinton’s server could have been pulled from unclassified sources including news reports.

“You want to go right to the source,” Gill said. “Go to the originating, not the collateral, authority. Investigative protocol would demand that.”

On Friday, Clapper spokesman Brian Hale confirmed that no change has been made to the two “Top Secrets” emails after a Politico report said the intelligence community was retreating from the finding.

“ODNI has made no such determination and the review is ongoing,” Hale said. Andrea G. Williams, spokeswoman for the intelligence community inspector general, said she had the same information. Kennedy is seeking an appeal, but no one can explain what statute or executive order would give Clapper that authority.

A U.S. government official who was not authorized to speak on the record said the FBI is identifying suspect emails, and then going directly to the agencies who originated them and therefore own the intelligence — and who, under the regulations, have final say on the classification.

As Fox News previously reported, at least four classified Clinton emails had their markings changed to a category that shields the content from Congress and the public, in what State Department whistleblowers believed to be an effort to hide the true extent of classified information on the former secretary of state’s server.

One State Department lawyer involved in the alleged re-categorization was Kate Duval. Duval once worked in the same law firm as Clinton’s current and long-time lawyer David Kendall and at the IRS during the Lois Lerner email controversy. Duval left government service for private practice in mid-September.

 

Iran Deal (JPOA) is Over, U.S. Relations, Broken

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Iran Reneges On Nuclear Deal  

“Adoption Day”–the day participants would start the process of implementing their JCPOA commitments – was set for October 18. On that day, therefore, the US and the EU began preparatory measures for lifting the multiple sanctions that have crippled Iran’s economy since they were first imposed in 2005. Only three days later, on October 21, Ayatollah Khamenei published a letter of guidelines to Iranian President Hassan Rouhani about the JCPOA.

This letter, the Middle East Media Research Institute (MEMRI) reported, was posted on Khamenei’s website in Persian, tweeted from his Twitter account, posted on his Facebook page in English, and published in English by the Iran Broadcasting Authority. In this document, clearly the definitive statement of the conditions under which Iran would be willing to execute the JCPOA, Iran’s Supreme Leader sets nine new and unilateral conditions that fundamentally change what was agreed on July 14. In short, he has virtually declared the JCPOA a dead letter.

What are these nine new conditions?

First Khamenei demands that sanctions are lifted fully, not suspended, before Iran takes steps to meet its obligations under the agreement. In addition he asserts that any endorsement by the West of the “snapback” option (the reintroduction of sanctions should Iran fail to meet the terms of the agreement) will be considered “non-compliance with the JCPOA”.

Secondly: Any future sanctions against Iran for whatever reason, including terrorism or human rights violations, will “constitute a violation of the JCPOA,” and a reason for Iran to stop executing the agreement.

Thirdly: Under the JCPOA Iran is obligated to start changing the function of its nuclear reactor at Arak and shipping out most of its stockpile of enriched uranium. In his letter Khamenei declares that Iran will not carry out these actions until after the International Atomic Energy Agency (IAEA) closes its dossier on Iran, targeted for December 15. But the IAEA will not be able to report about Iran meeting its obligations regarding the Arak reactor and shipping out its enriched uranium by the target date, because Iran is not going to do so by then. In short, the JCPOA has been thwarted from the very start.

Fourth: Iran will change the purpose of the Arak reactor only after there is a signed agreement on an “alternative plan” and “sufficient guarantee” that it will be implemented. In other words, Iran intends to postpone fulfilling its obligations under the JCPOA regarding the Arak reactor to some unknown future date.

Fifth: Iran intends to postpone indefinitely the date set by the JCPOA for shipping out its enriched uranium to another country in exchange for yellowcake. Moreover Khamenei is demanding that Iran receive in exchange for the enriched uranium not raw uranium as per the JCPOA, but instead uranium that has been enriched, albeit to a lower level than the uranium it ships out.

Sixth: Khamenei instructs President Rouhani, while reducing Iran’s ability to enrich uranium under the JCPOA, immediately to expand Iran’s ability to enrich uranium on a 15-year long-term plan for 190,000 centrifuges. In short, he is nullifying the declared goal of the JCPOA, which is to reduce Iran’s nuclear enrichment capabilities.

Seventh: The Iranian Atomic Energy Organization must ensure continued nuclear research and development, in its various dimensions, so that in eight years’ time, Iran will not be lacking in enrichment technology.

Eighth: Khamenei declares that Iran must be involved in resolving queries about the JCPOA – a recipe for unending dispute and the ability to paralyze the execution of the agreement.

Ninth: A new committee tasked with monitoring the execution of the agreement is to be established – nominally to obviate any attempt by the US or the West to cheat, but in effect, a mechanism for creating perpetual obstacles to carrying out the agreement.

So far world opinion has turned a blind eye to Khamenei’s virtual rejection of the nuclear agreement. The US and the EU are proceeding enthusiastically with the first stages of dismantling their multiple sanctions regimes. Government officials and businessmen from around the globe are making a beeline for Tehran, eager to share in the vast commercial opportunities they see awaiting.

The nuclear agreement is the basis for Iran’s re-entry into the comity of nations, and Khamenei seems to be setting the stage for a battle of wills between Iran and the West. Will the West’s desire to come to terms with Iran outweigh Iran’s determination to give away less than their president has actually signed up to? Will the West delay the lifting of sanctions? Who will blink first?

Rouhani says U.S.-Iran ties could be restored but U.S. must apologize

ROME (Reuters) – The nuclear deal reached between world powers and Iran could lead to better relations between Tehran and Washington if the United States apologized for past behavior, Iranian President Hassan Rouhani was quoted as saying on Thursday.

The pragmatist president, who championed the July 14 deal, has pushed for closer engagement with the West since his 2013 landslide election win.

But Iran’s top authority, Supreme Leader Ayatollah Ali Khamenei, has continued to rule out normalizing ties with the “Great Satan”, as he routinely calls the United States.

In an interview with Italy’s Corriere della Sera newspaper, Rouhani suggested that the United States and Iran could open embassies in each other’s capitals after decades of mutual hostility, but said Washington should apologize, without going into further detail.

“One day these embassies will re-open but what counts is behavior and the Americans hold the key to this,” Rouhani told the newspaper ahead of a trip to Italy this weekend, his first to a European capital.

“If they modify their policies, correct errors committed in these 37 years and apologize to the Iranian people, the situation will change and good things can happen.”

Iran and Washington severed ties shortly after the 1979 Islamic revolution when radical students seized the U.S. embassy in Tehran and held 52 Americans hostage for over a year.

Relations came under further pressure in the last decade over Iran’s nuclear ambitions.

Under the nuclear deal reached in July, Iran will curb its nuclear program in exchange for an easing of sanctions on its economy. Tehran denied Western suspicions it wanted to develop an atomic bomb.

Khamenei, who has the final say on all state matters, gave his conditional approval to the deal with six world powers including the United States, but has warned against allowing any U.S. political or economic influence on Iran.

Rouhani said Washington would have to fulfill its part in the nuclear accord for relations to improve. The United States approved conditional sanctions waivers for Iran, though these will not take effect until Tehran has complied with the nuclear accord.

“The way this agreement is applied can have an impact on the future,” Rouhani said in the interview.

“If it is well applied it can lay the foundation for fewer tensions with the United States, creating the conditions to open a new era. But if the Americans don’t respect their part of the nuclear accord, then surely our relationship will remain as it has been in the past,” he said.

Rouhani is due to see the Italian prime minister and business leaders during his Nov. 14-15 visit to Rome and will also hold talks with Pope Francis.

He will then fly to Paris for talks on Nov. 16-17.

VA Scheduler Whistleblower/Confessions

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FNC report and video here. Veterans Affairs Secretary Robert McDonald has made a point of giving out his personal contact information, to show how accessible he is as he works to overhaul the embattled agency.

But the bid backfired Thursday, after he urged one famous veteran dealing with poor treatment to contact him. When “Fox & Friends” tried his number, they reached his voicemail — and got a message to call back later as his voicemail was “full.”

TAMPA (FOX 13) – Bay Area veterans say they’re still facing excessive wait times for benefits and health care. The VA Inspector General found 307,000 veterans may have died waiting for access to the VA health care system.

Veterans who do get enrolled say significant delays for medical service persist.

“They gave me an appointment six months down the road, and then called to say they had to cancel,” said Winter Haven veteran Keith Brown. “It can be a year before you get the actual appointment.”

That conflicts with information provided by the Department of Veterans Affairs, which showing wait times have improved following the VA scandal of 2014.

Nick McSwain says there may be a reason for that. He said when he worked as a VA scheduler through the beginning of 2015, he was told to disregard patients’ desired dates for appointment, then note the actual scheduled date as the ‘desired’ date — thereby showing no delay based on what veterans requested.

“It says ‘What is the desired date’ (in the system) and instead of using that date, we use the appointment we actually give them so it shows no gap,” said McSwain.

He also claims veterans who complained had to wait even longer for future appointments.

“Vets who should have been seen top priority were passed over because of the way providers feel about this guy. They’d say ‘I hate this guy’ or ‘he’s annoying,” said McSwain, w

ho also noted that consults for specialty health care piled up when he worked in a scheduling center. “There have been times when stacks of consults disappeared.”

A spokeswoman for U.S. Rep. Gus Bilirakis said his district offices have opened 314 VA-related cases since January 2, 2015, pertaining to both benefits and health care.

FOX 13 asked the Department of Veterans Affairs to respond to a range of questions and issues raised by Thompson, Brown, and other veterans. The department answered our questions and provided data to show the VA is making progress and notable improvements since the national VA scandal broke in 2014.

The VA provided the following snapshot of data through November 1, 2015:

  1. Between June 1, 2014, and November 1, 2015, the electronic wait list (EWL) went from 56,271 appointments to 46,146, a 17.99 percent reduction.
  2. VHA created 2.5 million authorizations for Veterans to receive care in the private sector from October 29, 2014 through October 28, 2015. This represents a 3 percent increase in authorizations when compared to the same period in 2013/2014.

A spokeswoman at the James Haley Veterans Hospital and clinics also sent us an email including the following statement and response to our questions.

“James A. Haley Veterans’ Hospital and Clinics is a continuous improvement organization. We are always looking to improve processes and quality of care for our patients and their caregivers. As a matter of fact, we will be participating in the national VA Access Stand Down this Saturday. The Department of Veterans Affairs is committed to providing timely access to Veterans as determined by their clinical needs.  On Saturday, November 14, VA medical centers across the country will participate in a first ever National Access Stand Down.  A team of clinical leaders, administrators and volunteers will be on site at every VA medical center to reach out to all Veterans identified as having the most important and acute needs to make sure they can be seen either in VA or in the community – including here at JAHVH…”

The James A. Haley Veterans Hospital answered our questions as follows:

What are the current average wait times for primary care, specialty care and mental health care?

Our wait-times are published every two weeks, the same as other VA facilities and current and historical wait time and access data can be reviewed at: http://www.va.gov/health/access-audit.asp

Currently James A. Haley Veterans’ Hospital and Clinics average wait times are 1.33 days for Primary Care, 6.33 days for Specialty Care (just as in the public sector, length can vary significantly by Specialty Clinics) and 3.66 days for Mental Health.

JAHVH has more than 90,000 unique patients and we schedule between 4,000-5,000 appointments daily in all areas of our medical facilities and at our outpatient clinics and receive more than 46,000 consults per month in FY 15.

Every new consult is reviewed by a clinical provider as part of the triage process to determine the clinical urgency of the request. Patients are seen as soon as possible based on clinical review – the more acute the need – the faster the patient is scheduled for an appointment on average.
Do lengthy hold times by phone to schedule a doctor or specialist persist? 

Our average wait time to answer the phone is 49 seconds in FY 15 (the national goal is less than 30 seconds) and our abandonment rate is 3.9% (the national goal is less than 5%), but depending on the location within the medical center a person is calling, hold times and speed to answer the phones can vary. We recognize this can be one of the biggest areas of dissatisfaction with patients and the medical center has established a workgroup that is working to improve telephone access to all areas. Additionally, patients are encouraged to use secure messaging if possible to consult with their health care providers.

Are there safeguards to prevent veterans seeking medical appointments from being left on hold indefinitely?  If so, can they be worked around?

The phone system has different features throughout the medical center based on the volume of calls and staffing level of clinic areas.  One tool we use in high volume areas is the Automatic Call Distributor (ACD) lines. These lines will automatically roll over to the next available operator after a certain length of time. Also some clinics are piloting the use a call back feature for patients who choose not to wait on hold.  Secure messaging is always another option that patients can use to communicate with their providers, and if a patient has difficulty reaching a provider, we encourage patients to reach out to the Service Liaisons or Patient Advocates Office.

Do veterans in the Tampa Bay area continue to encounter lengthy delays to see a doctor or specialist once appointments are booked?

Again, wait times vary based on the type of care, but our average wait times range from 1.33 to 6.33 days. If a patient is unable to be seen at our facilities within 30 days of the clinically indicated/preferred date, that patient is offered care through the Choice program and is then eligible to receive care in the community. Wait times in the community can also be lengthy based on the availability of certain specialty care required and can be a longer wait than VA care in some cases.

We are continuously and proactively reviewing our high demand specialty areas to help further increase capacity and efficiencies. For example, we do “Super Saturday Clinics” in both Ortho and GI to reduce some of the current patient wait times and are actively working to fill vacant provider positions. JAHVH hiring emphasis has been on Patient Aligned Care Teams (Primary Care) and high demand Specialty Care Services to increase access, including Orthopedics, GI, Ophthalmology and Radiology and we’ve filled over 100 new FTE positions under VACAA funding including providers, nurses and support positions.

During FY 14, JAHVH activated more than 300,000 square feet of new space, which opened up space for specialty care to expand. JAHVH increased specialty care spaces from 34 to 84 exam rooms for a net increase of about 150%, including an additional:

  • 18 in Ortho
  • 14 in GI
  • 17 in Neurology to open in first quarter of FY16

Additionally, extended hours and weekend appointments are offered at Tampa, New Port Richey Outpatient Clinic, and Lakeland Community Based Outpatient Clinic.

How are consults (enabling veterans to seek specialty care) organized and accounted for to prevent them from getting lost?

Consults are managed and organized in compliance with the National Consult Management Business Rules. All notes are kept in individual patient records.

JAHVH also has a Consult Management Committee (CMC) and designated consult managers within each service who are responsible for ensuring the consults do not get lost. The CMC is a standing medical center-level committee designated to receive, monitor, analyze and address all aspects of consult management to meet the facility’s mission and commitment to timeliness of care, provide support to enhance communication of Veterans’ needs, and outcome of treatment.  As part of these activities, the CMC functions to coordinate the assessment, implementation, and management of consults and related VISTA structures with all other appropriate entities and reports these activities as appropriate. The CMC identifies opportunities for improvement, and recommends corrective action plans.

Have schedulers within the VA health care system ever been told by VA management to disregard regulations in any way?

Schedulers are trained to follow all scheduling guidelines. Refresher training is provided to schedulers when scheduling errors are identified through observation, periodic and scheduled audits, etc. There was refresher scheduling training completed for all staff who have scheduling options conducted between July – September 2015. Any staff that did not complete this training had their scheduling access removed.

Specifically, have schedulers been told to disregard ‘desired’ appointment dates, to avoid gaps between ‘desired’ dates and scheduled dates?  

Employees are fully and regularly trained and should never disregard regulations when making an appointment for patients. JAHVH is audited by both internal and external organizations to review and ensure data and appointment policies and procedures are followed correctly.  JAHVH executive leadership does not advocate or condone any data manipulation or scheduling irregularities. Should an instance of irregularity be identified, it would be reviewed and corrective action would be taken as necessary.

Have veterans who complain about poor service or delays been adversely affected (with longer waits) as a result of their complaints?

We encourage anyone with a specific concern to contact the hospital’s team of Patient Advocacy Specialists that work as liaisons for the Director’s Office and are on staff specifically to assist Veterans with any issues or concerns they may have. Additionally, we have Service Liaisons, who field incoming calls from Veterans and either answer their questions or route the individuals to the appropriate office to handle their concerns. JAHVH follows national scheduling guidelines and reviews all appointment and consult requests to ensure they are scheduled timely according to the patients’ clinical needs and condition.

For veterans who complain they are unable to utilize their choice cards as they would like, how does VA respond?

JAHVH follows the CHOICE Program rules based on the VACAA law that state a Veteran is eligible for non-VA care in the community if he/she lives more than 40 miles from a VA Facility (to include CBOCs even if they don’t offer the specialty) or if based on long wait times (patients that have an appointment scheduled greater than 30 days from when the clinically indicated/preferred date). Veterans may file an “excessive burden” appeal. Additionally, on July 31, 2015, the President signed Public Law 114-41, the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. Title IV, the VA Budget and Choice Improvement Act, makes several changes to the Veterans Choice Program. We are currently awaiting implementation guidance of these changes. More information about the choice program can be found: http://www.va.gov/opa/choiceact/